Falkenberg, Virginia R, Whistler, Toni, Murray, Janna R et al. · Genetics & epigenetics · 2013 · DOI
This study looked at how a stressful situation affects a type of immune cell protein called perforin in people with ME/CFS versus healthy people. Researchers gave both groups a stress test and measured changes in perforin levels and a chemical modification (methylation) that controls whether genes are turned on or off. They found that while both groups increased perforin during stress, people with ME/CFS had a lower peak response and differently regulated perforin levels afterward.
Understanding how stress affects immune cell function and gene regulation in ME/CFS could help explain why patients often experience worsening symptoms after stress or exertion. This research provides insight into epigenetic mechanisms—chemical switches controlling genes—that may differ in ME/CFS, potentially pointing toward new diagnostic or therapeutic targets.
This study does not prove that abnormal perforin regulation causes ME/CFS or that stress causes the illness. The findings are correlational and from acute stress responses in a lab setting; they do not establish whether these patterns relate to symptom severity, disease progression, or would persist in real-world chronic stress. The similar baseline PRF1 expression between groups contradicts some prior reports and requires replication.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Falkenberg, Virginia R, Whistler, Toni, Murray, Janna R, Unger, Elizabeth R, & Rajeevan, Mangalathu S (2013). Acute psychosocial stress-mediated changes in the expression and methylation of perforin in chronic fatigue syndrome.. Genetics & epigenetics. https://doi.org/10.4137/GEG.S10944
BibTeX
@article{mecfsatlas-falkenberg-2013-acute-psychosocial,
author = {Falkenberg, Virginia R and Whistler, Toni and Murray, Janna R and Unger, Elizabeth R and Rajeevan, Mangalathu S},
title = {Acute psychosocial stress-mediated changes in the expression and methylation of perforin in chronic fatigue syndrome.},
journal = {Genetics & epigenetics},
year = {2013},
doi = {10.4137/GEG.S10944},
note = {PubMed: 25512702},
url = {https://www.mecfsatlas.com/evidence/falkenberg-2013-acute-psychosocial},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/falkenberg-2013-acute-psychosocial
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